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2008 18th Annual Conference on State Mental Health Agency Services Research, Program Evaluation and Policy _____________________________________________________________________________________________

The Challenge Of The Black Hole Of Data

Authors/Presenters: Minakshi Tikoo, Ph.D. Director: Evaluation, Quality Management and Improvement Connecticut Dept. of Mental Health and Addiction Services Assistant Professor: University of Connecticut E-Mail: [email protected] Phone: (804) 418-6824 Michael J. Hettinger IT Analyst Connecticut Dept. of Mental Health and Addiction Services E-Mail: [email protected] Phone: (804) 418-6858

Abstract In most states providers perceive that the data they submit goes into a black hole. Mostly this perception is correct. Since 2005, Connecticut's Department of Mental Health and Addiction Services (DMHAS) has been engaged in an effort to change this provider perception and also improve the quality of the data that is used for decision-making. Every public system for mental health services has a management information system that collects and stores data, whether at the client or aggregate level. These data are often labeled as "useless" because nobody wants to vouch for their accuracy and integrity; hence they are not used for decision-making. It is an unspoken but acknowledged truth: "State data are dirty." DMHAS has successfully changed this in the last 18 months. DMHAS is using the philosophy of providing regular and standardized feedback as a method of improving data quality and ultimately the quality of care. Providers get feedback on the data that they submit monthly. A reason for providing feedback on these data regularly is so that, when analyses based on these data are provided to decision-makers and legislators, there is no surprise factor or disagreement about how these data were generated. DMHAS uses a continuous quality improvement model based on an information feedback loop with opportunities for exchange and discussion of ideas between DMHAS and providers. This is the first step toward informed decision-making. We currently provide feedback and discussion

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NRI 66 Canal Center Plaza, Suite 302 Alexandria, VA 22314 www.nri-inc.org

2008 18th Annual Conference on State Mental Health Agency Services Research, Program Evaluation and Policy _____________________________________________________________________________________________

forums in the form of reports, site visits, regular conference calls, and trainings at providers' request. We are reviewing how to adapt this feedback process/loop to better fit a personcentered-recovery-oriented system of care which values the quality of services. The missions of the Evaluation, Quality Management, and Improvement division are to demystify data for the providers by making it easy to use for day-to-day operation, and to implement program changes to better respond to clients' needs to and improve the overall standard and quality of care. DMHAS uses the Institute of Medicine's definition of quality of care: "Care that is safe, timely, efficient, effective, person-centered, and equitable." This presentation will cover the following topics: 1. A short overview of how most state data systems or units work 2. How many people does it take to do complete and maintain the feedback loop? 3. What does CT DMHAS do to mitigate the "Black Hole" problem? 4. How have the providers in CT reacted to this change in how the data is handled by DMHAS 5. Future plans for what we want to collaborate on with providers around the various uses of data 6. Working with people to ask the right questions 7. Assisting people understand the limitation and challenges to using the feedback loop approach

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NRI 66 Canal Center Plaza, Suite 302 Alexandria, VA 22314 www.nri-inc.org

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